New mothers should be strongly encouraged to engage in at least two hours of moderate to vigorous physical activity per week in the first three months following childbirth, according to a new guideline published in the British Journal of Sports Medicine. The recommendation emphasizes activities such as brisk walking and muscle-strengthening exercises to boost physical health and overall well-being.
In addition to physical activity, experts also advocate for daily pelvic floor muscle training to lower the risk of urinary incontinence and suggest strategies for improving sleep quality and duration.
The postpartum period, which extends after childbirth, is a critical time when women may experience increased risks of depression, weight retention, sleep disorders, diabetes, and cardiovascular disease, particularly following pregnancy complications. Despite these risks, clear guidance on postpartum physical activity has been notably absent.
In an effort to address this gap, a panel of researchers and clinicians conducted an in-depth review of 574 studies to provide evidence-based recommendations on physical activity, sedentary behavior, and sleep during the first year after childbirth. These guidelines are designed to be inclusive of all new mothers, regardless of breastfeeding status, gender, cultural background, disability, or socio-economic status.
The panel focused on 21 “critical” and “important” outcomes in postpartum health, consulting with new mothers to include concerns such as injury, mental health issues (including depression and anxiety), urinary incontinence, and fatigue, among others. The quality of evidence for each outcome was assessed using the GRADE system.
The recommendations emphasize that new moms, without any conditions preventing physical activity, should aim for at least 120 minutes of combined aerobic and resistance activities—such as brisk walking, cycling, and muscle-strengthening exercises—spread over four or more days a week in the first 12 weeks postpartum. For those with underlying health conditions, the guideline advises seeking medical advice before engaging in moderate physical activity.
Even with these tailored recommendations, the panel stresses that all new mothers should incorporate light daily physical activities, like gentle walking, to prevent the negative impacts of inactivity. They also recommend focusing on pelvic floor muscle training to help reduce the risk of urinary incontinence and to rehabilitate the pelvic floor muscles.
In terms of sleep, the panel underscores the importance of establishing healthy sleep routines—such as reducing screen time and creating a quiet, dark environment before bed—to support mental well-being.
Following these guidelines, new mothers are expected to experience a range of health benefits, including reduced depression, urinary incontinence, and low back pain. Additionally, improvements in weight, cholesterol levels, and fatigue are likely, with no adverse effects on breast milk quality or quantity.
While the panel acknowledges that adhering to these recommendations may not always be feasible, they emphasize that even incremental progress toward these goals can yield significant health benefits. They also highlight the minimal costs associated with following these guidelines, suggesting that the long-term health care savings for individuals and health systems would be substantial.
The panel concludes that, despite the need for further research, these recommendations provide substantial clinical value and should be integrated into postpartum care practices to promote better health outcomes for new mothers.
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